A case of long-term survival after resection of metastatic lymph nodes along the superior mesenteric vein from early gastric cancer

A 63-year-old man underwent distal gastrectomy and D1 + beta lymph node dissection for type II c early gastric cancer in the posterior wall of the antrum. In the fifth postoperative month, a mass appeared in the epigastric region, and serum tumor marker levels rose. Abdominal CT revealed a 4-cm mass anterior to the superior mesenteric vein. He was diagnosed with recurrence in the lymph nodes along the superior mesenteric vein (No. 14v). Since there was no evidence of recurrence elsewhere, the patient underwent resection of the lymph nodes and transverse colectomy, followed by five courses of chemotherapy with S-1 + cisplatin. At present, more than 38 months after surgery, he is alive without recurrence. Generally, chemotherapy is the first-line treatment for recurrent gastric cancer; however, surgery appears to be a treatment option if the tumor is localized and resectable.